TY - JOUR
T1 - Effects of ventilatory pattern on experimental lung injury caused by high airway pressure
AU - Simonson, Dana A.
AU - Adams, Alexander B.
AU - Wright, Laurel A.
AU - Dries, David J.
AU - Hotchkiss, John R.
AU - Marini, John J.
PY - 2004/3
Y1 - 2004/3
N2 - Objective: To determine the influence of clinician-adjustable ventilator settings on the development of ventilator-Induced lung injury, as assessed by changes in gas exchange (Pao 2), compliance, functional residual capacity, and wet weight to dry weight ratio. Design: Randomized in vivo rabbit study. Setting: Hospital research laboratory. Subjects: Forty-four anesthetized, mechanically ventilated adult rabbits. Interventions: Ventilation for 2 hrs with pressure control ventilation at 45 cm H 2O, Flo 2 - 0.6, and randomization to one of five ventilatory strategies using combinations of positive end-expiratory pressure (3 or 12 cm H 2O), inspiratory time (0.45, 1.0, or 2.0 secs), and frequency (9 or 23/min). Measurements and Main Results: Among the ventilator strategies applied, PEEP at 12 cm H 2O (elevated positive end-expiratory pressure) and inspiratory time at 0.45 secs (reduced inspiratory time) best preserved Pao 2 (p < .003) and compliance (p < .035). During Injury development, two consistent changes were observed: Tidal volume increased, and airway pressure waveform was transformed by extending the time to attain target pressure. Conclusions: In this preclinical model, lung injury was attenuated by decreasing inspiratory time. As lung injury occurred, tidal volume increased and airway pressure waveform changed.
AB - Objective: To determine the influence of clinician-adjustable ventilator settings on the development of ventilator-Induced lung injury, as assessed by changes in gas exchange (Pao 2), compliance, functional residual capacity, and wet weight to dry weight ratio. Design: Randomized in vivo rabbit study. Setting: Hospital research laboratory. Subjects: Forty-four anesthetized, mechanically ventilated adult rabbits. Interventions: Ventilation for 2 hrs with pressure control ventilation at 45 cm H 2O, Flo 2 - 0.6, and randomization to one of five ventilatory strategies using combinations of positive end-expiratory pressure (3 or 12 cm H 2O), inspiratory time (0.45, 1.0, or 2.0 secs), and frequency (9 or 23/min). Measurements and Main Results: Among the ventilator strategies applied, PEEP at 12 cm H 2O (elevated positive end-expiratory pressure) and inspiratory time at 0.45 secs (reduced inspiratory time) best preserved Pao 2 (p < .003) and compliance (p < .035). During Injury development, two consistent changes were observed: Tidal volume increased, and airway pressure waveform was transformed by extending the time to attain target pressure. Conclusions: In this preclinical model, lung injury was attenuated by decreasing inspiratory time. As lung injury occurred, tidal volume increased and airway pressure waveform changed.
KW - Animal model
KW - Barotrauma
KW - Mechanical
KW - Positive end-expiratory pressure
KW - Ventilation
KW - Ventilator strategy
KW - Ventilator-induced lung injury
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U2 - 10.1097/01.CCM.0000114825.03249.62
DO - 10.1097/01.CCM.0000114825.03249.62
M3 - Article
C2 - 15090962
AN - SCOPUS:1542719613
SN - 0090-3493
VL - 32
SP - 781
EP - 786
JO - Critical care medicine
JF - Critical care medicine
IS - 3
ER -